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correct dosage for methylphenidate er-la with wellbutrin xl?

I've been on bupropion xl 300mg for 7 years and it has truly changed my life. I used to have very severe Seasonal Affective Disorder and social anxiety, both of which have been all but cured with the medication. However, I have also struggled with ADD my entire life and now, finally, at 44, I have sought treatment for that as well. I was prescribed methylphenidate ER-LA 20mg. I am trying to determine the best strategy for taking these pills. I have been taking the bupropion first, then the methylphenidate about an hour later. I feel GREAT at first--focused, clear, calm. But then 4 hours later, I start to feel "buzzy" and anxious (I'm assuming around the time that the second wave releases).
My questions: Would it be better to take methylphenidate first and bupropion several hours later? Or just spread them out further? (Taking them at the same time creates the same anxiousness, so I'd like to stagger them.)  Or should I get a lower dosage of methylphenidate? (Or does this reaction really mean I do not have ADD?)
Also, I *love* coffee--but I fear caffeine on top of this mixture just makes it a bit too much.  Should I switch to decaf?
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189897 tn?1441126518
COMMUNITY LEADER
   Glad it is working for you.  Keep in touch!
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Avatar universal
Thanks so much for your help. I tried a few of your suggestions and I'm feeling much better. Protein in the morning, not too much caffeine, and spreading the doses out further has really helped. Perhaps it was just a couple of off days. I'm really feeling much more steady and focused and not "buzzy" the way I was when I wrote the initial post. Thanks again!
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189897 tn?1441126518
COMMUNITY LEADER
   Yes, the problem is that both of those meds stimulate dopamine and you may be getting a release at the same time from both of them.  Its probably going to take some trial and error to figure out the timing.  And its possible that you could even reduce the bupropion.   Make sure that you do all of this with your doctors knowledge and advice.  While the ADD med can be easily stopped, the bupropion not so much (although, I think it can be stepped down - just not suddenly stopped).   There really are lots of medication options.  This chart pretty well lists them all - http://www.leeheymd.com/charts/adhd_1.html
    And this page has info on Burpropion - http://www.crazymeds.us/pmwiki/Meds/Wellbutrin
     Since it is always possible that your ADD was at least partially the cause of your anxiety, and SAD can be pretty effectively treated with the correct lights in your house - it just might be possible to slowly get off the Burpropion and on to a stim med.  The advantage being that you can really take those as needed or more easily tailor them to your time schedule.
    Anyway, that is certainly a discussion that you want to have with your doctor.
     I do think there is a pretty good chance you do have ADD. That combination of meds would wire most people.
    Oh, I would make sure that you have a good high protein breakfast as it makes the meds last longer.
    And yes, I would certainly try spreading them out more.  And trying a lower dose of either one.  But here again - let your doctor know what you are doing.
   Hope this helps.
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